<!DOCTYPE html>
<html lang="zh-CN">
<head>
    <meta charset="UTF-8">
    <meta name="viewport" content="width=device-width, initial-scale=1.0">
    <title>康熙健康体检系统 - 体检预约</title>
    <style>
        * {
            margin: 0;
            padding: 0;
            box-sizing: border-box;
            font-family: 'Microsoft YaHei', sans-serif;
        }
        
        body {
            background-color: #f5f7fa;
            color: #333;
        }
        
        .header {
            background-color: #1a5276;
            color: white;
            padding: 20px 0;
            text-align: center;
            box-shadow: 0 2px 10px rgba(0, 0, 0, 0.1);
        }
        
        .header h1 {
            font-size: 28px;
            margin-bottom: 10px;
        }
        
        .container {
            max-width: 1000px;
            margin: 30px auto;
            padding: 0 20px;
        }
        
        .appointment-form {
            background-color: white;
            border-radius: 10px;
            padding: 30px;
            box-shadow: 0 5px 15px rgba(0, 0, 0, 0.05);
        }
        
        .form-title {
            color: #1a5276;
            margin-bottom: 30px;
            text-align: center;
            font-size: 24px;
            position: relative;
            padding-bottom: 15px;
        }
        
        .form-title:after {
            content: '';
            position: absolute;
            bottom: 0;
            left: 50%;
            transform: translateX(-50%);
            width: 80px;
            height: 3px;
            background-color: #3498db;
        }
        
        .form-row {
            display: flex;
            flex-wrap: wrap;
            margin-bottom: 20px;
        }
        
        .form-group {
            flex: 1;
            min-width: 250px;
            margin-right: 20px;
            margin-bottom: 15px;
        }
        
        .form-group:last-child {
            margin-right: 0;
        }
        
        label {
            display: block;
            margin-bottom: 8px;
            color: #555;
            font-weight: 500;
        }
        
        input, select, textarea {
            width: 100%;
            padding: 12px 15px;
            border: 1px solid #ddd;
            border-radius: 5px;
            font-size: 14px;
            transition: all 0.3s;
        }
        
        input:focus, select:focus, textarea:focus {
            border-color: #3498db;
            box-shadow: 0 0 0 3px rgba(52, 152, 219, 0.2);
            outline: none;
        }
        
        .radio-group {
            display: flex;
            align-items: center;
            margin-top: 8px;
        }
        
        .radio-option {
            display: flex;
            align-items: center;
            margin-right: 20px;
        }
        
        .radio-option input {
            width: auto;
            margin-right: 8px;
        }
        
        .package-container {
            margin-top: 30px;
        }
        
        .package-options {
            display: grid;
            grid-template-columns: repeat(auto-fill, minmax(300px, 1fr));
            gap: 20px;
            margin-top: 20px;
        }
        
        .package-card {
            border: 1px solid #ddd;
            border-radius: 8px;
            padding: 20px;
            cursor: pointer;
            transition: all 0.3s;
        }
        
        .package-card:hover {
            border-color: #3498db;
            box-shadow: 0 5px 15px rgba(0, 0, 0, 0.1);
        }
        
        .package-card.selected {
            border-color: #3498db;
            background-color: #f0f8ff;
        }
        
        .package-card h3 {
            color: #1a5276;
            margin-bottom: 10px;
        }
        
        .package-card p {
            color: #666;
            margin-bottom: 15px;
            line-height: 1.5;
        }
        
        .package-price {
            font-weight: bold;
            color: #e74c3c;
            font-size: 18px;
        }
        
        .submit-btn {
            display: block;
            width: 200px;
            margin: 40px auto 0;
            padding: 12px;
            background-color: #1a5276;
            color: white;
            border: none;
            border-radius: 5px;
            font-size: 16px;
            font-weight: 500;
            cursor: pointer;
            transition: background-color 0.3s;
        }
        
        .submit-btn:hover {
            background-color: #154360;
        }
        
        .footer {
            background-color: #2c3e50;
            color: white;
            text-align: center;
            padding: 20px 0;
            margin-top: 50px;
        }
        
        @media (max-width: 768px) {
            .form-group {
                flex: 100%;
                margin-right: 0;
            }
            
            .package-options {
                grid-template-columns: 1fr;
            }
        }
    </style>
</head>
<body>
    <div class="header">
        <h1>康熙健康体检系统</h1>
        <p>专业体检预约服务</p>
    </div>
    
    <div class="container">
        <form class="appointment-form" id="appointmentForm">
            <h2 class="form-title">体检预约</h2>
            
            <div class="form-row">
                <div class="form-group">
                    <label for="name">姓名</label>
                    <input type="text" id="name" name="name" required>
                </div>
                
                <div class="form-group">
                    <label for="idCard">身份证号</label>
                    <input type="text" id="idCard" name="idCard" required>
                </div>
            </div>
            
            <div class="form-row">
                <div class="form-group">
                    <label for="phone">手机号码</label>
                    <input type="tel" id="phone" name="phone" required>
                </div>
                
                <div class="form-group">
                    <label for="birthDate">出生日期</label>
                    <input type="date" id="birthDate" name="birthDate" required>
                </div>
            </div>
            
            <div class="form-row">
                <div class="form-group">
                    <label>性别</label>
                    <div class="radio-group">
                        <div class="radio-option">
                            <input type="radio" id="male" name="gender" value="male" checked>
                            <label for="male">男</label>
                        </div>
                        <div class="radio-option">
                            <input type="radio" id="female" name="gender" value="female">
                            <label for="female">女</label>
                        </div>
                    </div>
                </div>
                
                <div class="form-group">
                    <label for="appointmentDate">预约日期</label>
                    <input type="date" id="appointmentDate" name="appointmentDate" required>
                </div>
            </div>
            
            <div class="form-group">
                <label for="branch">体检分院</label>
                <select id="branch" name="branch" required>
                    <option value="">请选择分院</option>
                    <option value="beijing">北京总院</option>
                    <option value="shanghai">上海分院</option>
                    <option value="guangzhou">广州分院</option>
                    <option value="shenzhen">深圳分院</option>
                    <option value="chengdu">成都分院</option>
                </select>
            </div>
            
            <div class="form-group">
                <label for="notes">备注信息</label>
                <textarea id="notes" name="notes" rows="3"></textarea>
            </div>
            
            <div class="package-container">
                <h3>选择体检套餐</h3>
                <div class="package-options">
                    <div class="package-card" onclick="selectPackage(this)">
                        <h3>基础体检套餐</h3>
                        <p>包含常规体检项目：血常规、尿常规、心电图、胸透、肝功能等基础检查。</p>
                        <div class="package-price">¥580</div>
                        <input type="radio" name="package" value="basic" style="display: none;" checked>
                    </div>
                    
                    <div class="package-card" onclick="selectPackage(this)">
                        <h3>全面体检套餐</h3>
                        <p>在基础套餐上增加：肿瘤标志物筛查、骨密度检测、颈动脉彩超等全面检查。</p>
                        <div class="package-price">¥1280</div>
                        <input type="radio" name="package" value="comprehensive" style="display: none;">
                    </div>
                    
                    <div class="package-card" onclick="selectPackage(this)">
                        <h3>精英体检套餐</h3>
                        <p>最全面的体检项目：包含全身CT扫描、胃肠镜检查、基因检测等高端项目。</p>
                        <div class="package-price">¥2580</div>
                        <input type="radio" name="package" value="premium" style="display: none;">
                    </div>
                </div>
            </div>
            
            <button type="submit" class="submit-btn">提交预约</button>
        </form>
    </div>
    
    <div class="footer">
        <p>© 2025 康熙健康体检系统 版权所有</p>
    </div>
    
    <script>
        // 选择体检套餐
        function selectPackage(card) {
            const cards = document.querySelectorAll('.package-card');
            cards.forEach(c => c.classList.remove('selected'));
            card.classList.add('selected');
            const radio = card.querySelector('input[type="radio"]');
            radio.checked = true;
        }
        
        // 表单提交
        document.getElementById('appointmentForm').addEventListener('submit', function(e) {
            e.preventDefault();
            
            // 这里可以添加表单验证逻辑
            const name = document.getElementById('name').value;
            const phone = document.getElementById('phone').value;
            
            if (!name || !phone) {
                alert('请填写完整信息');
                return;
            }
            
            // 模拟提交成功
            alert('预约提交成功！我们的工作人员会尽快与您确认预约信息。');
            this.reset();
            
            // 实际应用中这里应该是AJAX提交到服务器
            // console.log('Form data:', new FormData(this));
        });
        
        // 设置默认预约日期为明天
        window.onload = function() {
            const tomorrow = new Date();
            tomorrow.setDate(tomorrow.getDate() + 1);
            const formattedDate = tomorrow.toISOString().split('T');
            document.getElementById('appointmentDate').value = formattedDate;
            
            // 默认选中第一个套餐
            document.querySelector('.package-card').classList.add('selected');
        };
    </script>
</body>
</html>
